In high-income countries, poverty is often associated with higher average body mass index (BMI). To account for this reverse gradient, deprivation theories posit that declining economic resources make it more difficult to maintain a healthy weight. By contrast, discrimination theories argue that anti-fat discrimination in hiring and marriage sorts heavier individuals into lower-income households. This study assesses competing predictions of these theories by examining how household income in representative samples from South Korea (2007–2014, N=20,823) and the US (1999–2014, N=6395) is related to BMI in two key contrasting groups: (1) currently-married and (2) never-married individuals. As expected by anti-fat discrimination in marriage, the reverse gradient is observed among currently-married women but not among never-married women in both countries. Also consistent with past studies no evidence was found for a reverse gradient among men. These findings are consistent with anti-fat discrimination in marriage as a key cause of the reverse gradient and raise serious challenges to deprivation accounts as well as explanations based on anti-fat discrimination in labour markets.

中文翻译：

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剥夺还是歧视？比较美国和韩国收入-肥胖梯度反向的两种解释

在高收入国家，贫困通常与较高的平均体重指数 (BMI) 相关。为了解释这种反向梯度，剥夺理论假设经济资源的减少使保持健康体重变得更加困难。相比之下，歧视理论认为，招聘和婚姻中的反肥胖歧视将体重较重的人分类为低收入家庭。本研究通过研究韩国代表性样本中的家庭收入（2007-2014 年，ñ=20,823) 和美国 (1999–2014,ñ=6395）与两个主要对比组的 BMI 相关：（1）当前已婚和（2）未婚个体。正如婚姻中的反脂肪歧视所预期的那样，在当前已婚女性中观察到反向梯度，但在两国的未婚女性中没有观察到。同样与过去的研究一致，没有发现男性之间存在反向梯度的证据。这些发现与婚姻中的反脂肪歧视是反向梯度的一个关键原因一致，并对剥夺账户以及基于劳动力市场反脂肪歧视的解释提出了严峻挑战。